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General NPI Number Information
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NPI Number | 1346495199
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Entity Type | Individual
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Provider Name | MARK CELESTIE ORNOPIA CAGATA RPT, DPT
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Gender | Male
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 21530 HILLSIDE AVE
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City | QUEENS VILLAGE
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State | NY
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Zip | 11427-1831
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Country | US
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Telephone | 718-776-1863
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Fax | 718-732-2161
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Provider Business Mailing Address
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Address Line | 55 STRATFORD RD
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City | PLAINVIEW
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State | NY
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Zip | 11803-2634
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Country | US
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Telephone | 347-331-1051
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 029020
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License Number State | NY
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